The Journal of Bone and Joint Surgery, Vol 60, Issue 7 973-977, Copyright © 1978 by Journal of Bone and Joint Surgery, Inc
Results of surgical treatment for non-union after high tibial osteotomy in osteoarthritis of the knee
B Tjornstrand, B Hagstedt and BM Persson
In a series of 280 high tibial osteotomies performed for osteoarthritis of
the knee between 1969 and 1975, there were ten cases of pseudarthrosis, an
incidence of 3.6 per cent. These ten knees (and an additional two that were
referred to us) were reoperated on. In most cases the pseudarthrosis was
resected and stabilized with the Charnley transfixation-compression method.
Other procedures involved resection without compression (one knee),
compression blade-plate fixation, and arthroplasty with a hinge
endoprosthesis. All osteotomies healed eventually with the knee in
satisfactory position. In spite of the initial non-union and repeated
operation, all twelve patients eventually had satisfactory correction of
the preosteotomy deformity, and none had a loss in walking ability. All but
two patients had freedom from pain. We concluded that patients with
non-union following high tibial osteotomy for osteoarthritis of the knee
should undergo resection of the pseudarthrosis and transfixation
compression as the treatment of choice. Endoprosthetic replacement then can
be used as a salvage procedure if it is needed.
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